Jusiene Roma, Kucinskas Vaidutis
Department of Psychology, Law University of Lithuania, Vilnius, Lithuania.
Med Sci Monit. 2004 Mar;10(3):CR102-7. Epub 2004 Mar 1.
Children with phenylketonuria of early onset under continuous treatment are considered at higher risk for psychological maladjustment than children without other chronic diseases. The aim of the present study was to evaluate the psychological adjustment of Lithuanian children with treated phenylketonuria and analyze it in the context of the psychological adjustment of their parents.
MATERIAL/METHODS: The parents of 37 early-treated children (age 4-14 years old) with phenylketonuria and of 37 matched controls were asked to fill out the Child Behavior Checklist and questionnaire on stress coping strategies. Parents of children with phenylketonuria answered a questionnaire on reactions to the child's disease and its impact on the family.
Lithuanian children with treated phenylketonuria have significantly more emotional and behavioral problems than healthy controls. They are more withdrawn, anxious/depressed, have more social and attention problems. The higher rates of internalizing and total problems are related to parental maladjustment (feelings of guilt and anger) together with maladaptive (emotional) everyday stress coping strategies. These last two factors promote overindulging the child, which is also a predictor of psychological maladjustment in children with phenylketonuria.
The already existing organic vulnerability may account for the greater susceptibility of children with phenylketonuria to psychological risk factors, as for example parental inability to cope adequately with everyday stress related to the demands of disease and its treatment.
持续接受治疗的早发型苯丙酮尿症患儿被认为比无其他慢性病的儿童出现心理适应不良的风险更高。本研究的目的是评估立陶宛接受治疗的苯丙酮尿症患儿的心理适应情况,并在其父母心理适应的背景下进行分析。
材料/方法:37名接受早期治疗的苯丙酮尿症患儿(4 - 14岁)的父母以及37名匹配的对照组儿童的父母被要求填写儿童行为检查表和关于压力应对策略的问卷。苯丙酮尿症患儿的父母回答了一份关于对孩子疾病的反应及其对家庭影响的问卷。
接受治疗的立陶宛苯丙酮尿症患儿比健康对照组有明显更多的情绪和行为问题。他们更孤僻、焦虑/抑郁,有更多社交和注意力问题。内化问题和总问题的较高发生率与父母适应不良(内疚和愤怒情绪)以及适应不良(情绪化)的日常压力应对策略有关。最后这两个因素促使对孩子过度溺爱,这也是苯丙酮尿症患儿心理适应不良的一个预测因素。
已存在的器质性易损性可能解释了苯丙酮尿症患儿对心理风险因素更易感性,例如父母无法充分应对与疾病及其治疗需求相关的日常压力。